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    Concepts in Hip Trauma

    Dr Terence Dsouza, M.SDept of Orthopedics

    Father Muller Medical College

    Mangalore

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     Topics

    • Hip dislocations

    • Neck of femur fractures

    •

    ntertrochanteric fractures

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    H! DS"OC#TONS

    • !osterior dislocation$MC%$&T#'s%

      $Thompson (psteins Classi)cation%

    •

    #nterior dislocation• Central dislocation

    • Hip dislocations *ith aceta+ular 's

    •

    Hip disocations *ith femoral head's$!ipkins%

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    C"NC#" - / F(#T0&(S

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    Methods of reduction

    • Bigelo*s $not done, high risk of 's%

    • Allis $usuall1 foll*ed%

    •

    Stimpsons gra2it1 method• East +altimore lift

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    #llis - Stimpsons

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    NOF

    !au*els classi)cation3 importance44

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    5ardens stages666

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    Complications

    • Osteonecrosis 7 non union 7 arthritis

    • Osteonecrosis3

      Subcapital7 Transcer2ical7 +asal 

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    8h1 non union in NOF

    • ntracapsular 9 S/NO:#" F"0D;dilutes< #F

    • No periosteal la1er

    • !recarious +lood suppl1

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     Treatment of NOF

    • = >?3 C&F or O&F

    • 7@?3 Hemiarthroplast1

    •

     >?;@?3 C&F A Hemi• !re eBisting arthritis3 TH&

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    Osteos1nthesis for NOF 's

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    0nipolar hemiarthrolast1

    $ #M!AThompson's%

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    ipolar hemiarthroplast1

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     TH&

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    ra1

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    Mc murra1 osteotom1

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    T FCT0&(S

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    CF

    • (& lo*er lim+$ T7 NOF %

    • Shortening$ T7 NOF%

    •

     Tenderness at 5T$ NOF scarpastriangle%

    • 0na+le to *alk$ ma1+e a+le to *alkin impacted NOF%

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    !oints to remem+er

    • Malunion$ MC%

    •  Treatment 3

      !FN$ cephalomedullar1 nail%  DHS$ d1namic hip scre*%

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    DHSA!FN


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